Presence of Mind: Tips for Combatting Chemo Brain

A CANCER DIAGNOSIS COMES with a laundry list of physical and emotional side effects, and a variety of resources can help patients deal with them.

Unfortunately, those resources don’t offer quick fixes for problems including mental fogginess, short-term memory trouble, multitasking difficulties and slower mental acuity compared with before diagnosis. Often referred to as chemo brain, these cognitive changes are a common side effect of many types of cancer treatments — not just chemotherapies, as the term suggests.

Although strategies for improving mental sharpness after cancer treatment already exist, new and more effective techniques are being sought. In a study funded by the Oncology Nursing Society Foundation, one nurse researcher determined that adding a mindfulness aspect to post-treatment exercise can help ease chemo brain.

To explore this avenue, Oncology Nursing Society member Jamie Myers, Ph.D., RN, AOCNS, a research assistant professor at the University of Kansas Medical Center School of Nursing in Kansas City, measured the effectiveness of using qi gong, a mindfulnessbased exercise, to mitigate the effects of chemo brain in patients with breast cancer.

STUDYING QI GONG

Myers’ study, which is being reviewed pending publication, recruited women with breast cancer who received chemotherapy and finished their treatment at least two months prior to enrollment. Qi gong, a low-intensity exercise, combines physical activity (slow, flowing movement) with mindfulness techniques (deep breathing and meditation). It was selected for study because it can be done standing or sitting and regardless of fitness level.

“Our participants had concerns about their mental abilities and difficulties they were experiencing with memory and multitasking,” Myers said. “We randomized participants to one of three groups that met once a week for eight weeks. The first group met and practiced qi gong, the second engaged in gentle exercise with no mindfulness element, and the third attended a support group tailored to the needs of women with the breast cancer experience.”

Participants rated their own mental abilities using a validated questionnaire, and Myers’ team also tested their cognitive function. “At baseline and a month after the groups ended, we had participants complete a short series of cognitive tests that went along with how they were reporting their own mental abilities,” Myers said. “We wanted to have both subjective and objective results that we could compare pre- and post-study.”

THE IMPACT OF QI GONG

After eight weeks and continued follow-up, Myers’ team noted that, of all three groups, the patients who engaged in qi gong experienced the most improvement in self-reported memory, multitasking and other mental abilities. “We saw significant improvement for the women in the qi gong group,” Myers said. “Also, when we initially assessed for their baseline abilities, we asked them about stress levels, fatigue and sleep habits. The qi gong group reported the biggest reduction of stress levels compared with all other groups.”

Myers and her team recognized the time commitment involved with following a program an hour a week for eight weeks. Some patients left the study as a result, she said, but those who remained were enthusiastic and engaged. Classes in qi gong and other mindfulness-based exercises could be offered online using services such as Skype, according to Myers. However, practicing qi gong is not appropriate for everyone, she said, so patients should consult their health care providers for more information.

“We have to be careful not to overstate the study,” Myers said, “but we were excited to see that our small study indicated that adding a mindfulness component to exercise could enhance the benefits for patients. Mindfulness-based exercise can be added as a piece of a patient’s arsenal, but it depends on the individual patient’s condition.”

DRIVING NEW RESEARCH

With support from the Oncology Nursing Society Foundation and its donors, Myers and many other oncology nurse scientists continue to drive patient-centered research, leading to practice change and improved quality of life for patients with cancer.

“We were thrilled when we heard our grant application was approved,” Myers said. “It’s the only way we could’ve done this work. Whether it’s as researchers conducting the studies, as oncology nurses supporting patients or as patients journeying through a cancer diagnosis, the support the Oncology Nursing Society Foundation provides is critical to laying the groundwork for future studies.”
The ONS Foundation is the only entity that directly supports the projects of oncology nurses like Jamie Myers. For more information about the ONS Foundation and ways to give, visit ONSFoundation.org.